Individual
DR. MARIE CAVUOTO PETRIZZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD, MSED
Contact information
Practice address
865 NORTHERN BLVD STE 101, GREAT NECK, NY 11021-5310
(516) 622-5070
Mailing address
500 HOFSTRA UNIVERSITY # W222, HEMPSTEAD, NY 11549-5000
(516) 463-7476
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
223738
NY
2080P0201X
Pediatric Allergy/Immunology Physician
223738
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02684022
—
NY
Enumeration date
10/03/2006
Last updated
04/22/2021
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